Kama Brown:

Oklahoma Medicaid recipients deserve the privilege of hospice care. Prior-authorization is not required for Medicare recipients, and with commercial insurance if a prior-auth. is required is usually instant up to 24hrs from the time hospice receives the referral and verifies benefits. Quick turn around time is a must for hospice patients, as many are are so critical they may only last hours to days. Days to weeks to wait on prior auths. is a disservice to the Medicaid recipient and the hospices who want to care for the patient but are taking the risk of providing immediate care to the patient without guarantee of reimbursement. This slows down the availability of hospices to serve the Medicaid population to the desired extent of providing hospice care to all who need it at the time they need it. Having to obtain prior auths. prior to a change in level of care, is not always a possibility when the prior auths. turn around time is days to weeks. Most level of care changes to GIP or CC are emergent needs of the patient. When a denial happens with the prior auths. a detailed explanation of why it was denied is desired this way a correction and resubmittal can be done. We will never learn this process if details of the denial and how to correct are never given. A state wide education on the new process for this Medicaid reimbursement method is needed. By offering a few separate educational offerings may help avoid mistakes, call and email back logs as the hospices are learning this system. I look forward to being able to offer Medicaid patients the gift of hospice, this is a long awaited change to Oklahoma that is exciting to be a part of.